Journal of Clinical Nursing Impact Factor & Information

Publisher: Wiley

Journal description

Journal of Clinical Nursing is the ideal information resource for nurses everywhere seeking to enhance their practice. Focusing directly on the theory and practice of nursing and highlighting matters of concern to practising nurses, Journal of Clinical Nursing covers important issues such as: the developing role of nurses and those who assist them; the relationship of nursing theory to current practice; methods of assessment, planning, intervention and evaluation; the clarification of concepts relevant to nursing practice; the organization of clinical nursing work; the nature of clinical nursing expertise; quality assurance in nursing; teamwork in health care; the integration of clinical, educational and research work.

Current impact factor: 1.26

Impact Factor Rankings

2015 Impact Factor Available summer 2015
2013 / 2014 Impact Factor 1.233
2012 Impact Factor 1.316
2011 Impact Factor 1.118
2010 Impact Factor 1.228
2009 Impact Factor 1.194
2008 Impact Factor 1.376

Impact factor over time

Impact factor
Year

Additional details

5-year impact 1.77
Cited half-life 5.00
Immediacy index 0.21
Eigenfactor 0.01
Article influence 0.45
Website Journal of Clinical Nursing website
Other titles Journal of clinical nursing (Online)
ISSN 1365-2702
OCLC 45498353
Material type Document, Periodical, Internet resource
Document type Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details

Wiley

  • Pre-print
    • Author can archive a pre-print version
  • Post-print
    • Author cannot archive a post-print version
  • Restrictions
    • 12 months embargo
  • Conditions
    • Some journals have separate policies, please check with each journal directly
    • On author's personal website, institutional repositories, arXiv, AgEcon, PhilPapers, PubMed Central, RePEc or Social Science Research Network
    • Author's pre-print may not be updated with Publisher's Version/PDF
    • Author's pre-print must acknowledge acceptance for publication
    • Non-Commercial
    • Publisher's version/PDF cannot be used
    • Publisher source must be acknowledged with citation
    • Must link to publisher version with set statement (see policy)
    • If OnlineOpen is available, BBSRC, EPSRC, MRC, NERC and STFC authors, may self-archive after 12 months
    • If OnlineOpen is available, AHRC and ESRC authors, may self-archive after 24 months
    • Publisher last contacted on 07/08/2014
    • This policy is an exception to the default policies of 'Wiley'
  • Classification
    ​ yellow

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: To analyse the Braden Scale scores and sub-scores assessed in Portuguese hospitalised adult patients in association with their characteristics, diagnoses and length of stay. The Braden Scale is used worldwide for pressure ulcer risk assessment and supports nurses in the implementation of preventive interventions. Retrospective cohort analysis of electronic health record database from adult patients admitted to medical and surgical areas during 2012. Braden Scale scores and sub-scores of 8147 patients were associated with age, gender, type of admission (emergency service or programmed), specialty units (medical or surgical), length of stay, patient discharge (discharge, decease or transference to other hospital) and ICD-9 diagnosis. The participants with significantly lower Braden Scale scores were women, older people, hospitalised in medical units, with emergency service admission, longer hospitalisation stays and/or with vascular, traumatisms, respiratory, infection or cardiac diseases. Mobility, friction/shear forces and activity had higher contributions to the Braden Scale score, while nutrition had the lowest contribution. Approximately one-third of all participants had high risk of pressure ulcer development at admission, which led to the application of nursing preventive care. Our study demonstrated that nurses should pay special attention to patients over 50 years of age, who had significantly lower Braden Scale scores. The Braden Scale scores significantly increased in the last assessments showing that Braden Scale is sensitive to the clinical improvement of the patient. Braden Scale correlations with length of stay reveal its importance as predictor of length of stay. Nurses should use Braden Scale assessment and consider patients' characteristics and diagnoses to plan more focused preventive interventions and improve nursing care. This study could be the first step to create a preventive protocol based on institutional reality, patients' characteristics, level of risk and affected sub-scales. © 2015 John Wiley & Sons Ltd.
    Journal of Clinical Nursing 08/2015; DOI:10.1111/jocn.12927
  • [Show abstract] [Hide abstract]
    ABSTRACT: To offer an explanation of how registered nurses' are providing care to hospitalised older adults in nursing teams comprised of a variety of roles and educational levels. Around the globe economic pressures, nursing shortages and increased patient acuity have resulted in tasks being shifted to healthcare workers with less education and fewer qualifications than registered nurses. In acute care hospitals, this often means reducing the number of registered nurses and adding licensed practical nurses and care aides (also referred to as unregulated healthcare workers) to the nursing care team. The implications of these changes are not well understood especially in the context of hospitalised older adults, who are complex and the most common care recipients. Thematic analysis of data that were collected in a previous grounded theory study to provide an opportunity in-depth analysis of how nurses provided care to hospitalised older adults within nursing teams. Data collected in western Canada on two hospital units in two different health authorities were analysed in relation to how nursing teams provide care. Hand coding and thematic analysis were employed. The themes of scrutinised skill mix and working together highlighted how the established nursing value of reciprocity is challenging to enact in teams with a variety of scopes of practice. The value of reciprocity both aided and hindered the nursing team in engaging in team behaviours to effectively manage patient care. Educators and leaders could assist the nursing care team in re-thinking how they engage in teamwork by providing education about roles and communication techniques to support teams and ultimately improve nursing care. The value of reciprocity within nursing teams needs to be re-examined within the context of team members with varying abilities to reciprocate in kind. © 2015 John Wiley & Sons Ltd.
    Journal of Clinical Nursing 08/2015; DOI:10.1111/jocn.12961
  • [Show abstract] [Hide abstract]
    ABSTRACT: This study aimed to identify the approaches used by nurses to address the sensory requirements of patients to respond to the concerns and needs in this area. Preventing sensory problems is very important for intensive care nurses as these problems may cause various additional health problems in intensive care patients; however, no study has evaluated the approaches used by nurses in this respect. The study was conducted as a descriptive study in all internal medicine intensive care units at hospitals located within the borders of the metropolitan municipality in the capital city of Turkey. Data were collected using case forms that were developed through expert opinions to identify the approaches of nurses for the sensory requirements of patients. The study was conducted with 95 nurses who agreed to be involved in the study of the 107 internal medicine intensive care nurses in the research population. Most of the nurses (86·3%) who took part in this study indicated that intensive care patients had sensory requirements, but 80% clarified that their priority was to maintain life support and to meet their physiological needs. Almost all of the nurses were able to accurately identify the specific sensory problems of the six different ones in cases that were assigned to them. However, this ratio decreased when identifying the proper approach for the given sensory requirement. Nurses were able to identify sensory requirements of patients, but they do need support in deciding the appropriate management approach. This study may fill the gap in the literature regarding the approaches of nurses towards sensory requirements and to provide contribution for future research. To help intensive care patients with sensory problems, nurses should routinely assess patients' psychology and should do appropriate interventions. © 2015 John Wiley & Sons Ltd.
    Journal of Clinical Nursing 08/2015; DOI:10.1111/jocn.12965
  • [Show abstract] [Hide abstract]
    ABSTRACT: To describe goals set in individual nurse-led lifestyle counselling sessions in leg ulcer patients, and to explore patient and goal characteristics in relation to health behaviour change. Goal setting is increasingly used in nurse-led counselling programmes, but the delivery is often unknown, especially in patient groups for which only recently programmes have been developed, such as patients with venous leg ulcers. A secondary analysis of data collected in the intervention arm of a randomised clinical trial of counselling sessions in venous leg ulcer patients. Nursing records (n = 71) were explored for the number of goals set, topic, quality and course of goals during the trajectory. Furthermore, goals and patient characteristics were compared in relation to health behaviour change. Forty-one patients (58%) succeeded in changing their behaviour after setting a goal. Setting goals for conducting leg exercises was chosen by most patients in this study, goals for adherence with compression therapy were chosen the least. Sixty-eight per cent of the goals met criteria for being Specific, Measurable and Time-bound. Patients who achieved behaviour change were significantly younger compared to the patients who did not. Except for age, there were no differences in characteristics between the group that did and did not achieve behaviour change. Goal setting could be improved by setting goals more Specific, Measurable and Time-bound, and by setting goals on an essential topic for behaviour change. This explorative study did not show that goal characteristics, including the quality of goals, were related to patients' behaviour change. The delivery of goal setting in this programme, and most likely in similar programmes, could be improved. Regular quality checks in daily goal setting practice should be considered. More research is needed into how to best provide health promotion to frail and elderly people. © 2015 John Wiley & Sons Ltd.
    Journal of Clinical Nursing 08/2015; DOI:10.1111/jocn.12955
  • [Show abstract] [Hide abstract]
    ABSTRACT: The purpose of this review was to identify and categorise the components of the content and structure of effective self-management interventions for patients with inflammatory bowel disease. Inflammatory bowel diseases are chronic gastrointestinal disorders impacting health-related quality of life. Although the efficacy of self-management interventions has been demonstrated in previous studies, the most effective components of the content and structure of these interventions remain unknown. A systematic review, meta-analysis and meta-regression of randomised controlled trials was used. A systematic search of six electronic databases, including Pubmed, Embase, Cochrane central register of controlled trials, Web of Science, Cumulative Index of Nursing and Allied Health Literature and Chinese Biomedical Literature Database, was conducted. Content analysis was used to categorise the components of the content and structure of effective self-management interventions for inflammatory bowel disease. Clinically important and statistically significant beneficial effects on health-related quality of life were explored, by comparing the association between effect sizes and various components of self-management interventions such as the presence or absence of specific content and different delivery methods. Fifteen randomised controlled trials were included in this review. Distance or remote self-management interventions demonstrated a larger effect size. However, there is no evidence for a positive effect associated with specific content component of self-management interventions in adult patients with inflammatory bowel disease in general. The results showed that self-management interventions have positive effects on health-related quality of life in patients with inflammatory bowel disease, and distance or remote self-management programmes had better outcomes than other types of interventions. This review provides useful information to clinician and researchers when determining components of effective self-management programmes for patients with inflammatory bowel disease. More high-quality randomised controlled trials are needed to test the results. © 2015 John Wiley & Sons Ltd.
    Journal of Clinical Nursing 08/2015; DOI:10.1111/jocn.12851
  • [Show abstract] [Hide abstract]
    ABSTRACT: To provide deeper insights into the experiences of lesbian women in accessing cervical cancer screening and to inform strategies to increase the uptake of these services for this group of women. Lesbian women continue to face significant health disparities and are at increased risk for specific medical conditions. With cervical cancer being largely a preventable disease, early detection through the Papanicolaou test is crucial, as it enables treatment to commence early and limit the progression of the disease. Although the rates of cervical abnormalities among lesbian women are similar to that of the general population, lesbian women are less likely to have regular cervical screening. The reasons for this are largely unknown and there is a paucity of research that explores cervical cancer screening in lesbian women. Qualitative descriptive design. Participants (n = 9) were recruited via media release and those living in New South Wales who self-identified as lesbian, meeting the inclusion criteria were recruited for the study. Semi-structured, face to face and telephone interviews were used to obtain narrative data from lesbian women on their experiences of cervical screening. Three main themes emerged from the data: 'Lack of opportunistic screening'; 'Fear of penetration' and 'Encountering heterosexism and discrimination'. This current study builds on existing knowledge and further, has identified issues that have not been previously raised in the literature. New findings from this study highlight participants' fear of penetration, and stigma associated with accessing information, as substantial barriers to cervical screening. This study's findings can guide future research and highlight possibilities for specific strategies to reduce health disparities among lesbian women. © 2015 John Wiley & Sons Ltd.
    Journal of Clinical Nursing 08/2015; DOI:10.1111/jocn.12947
  • [Show abstract] [Hide abstract]
    ABSTRACT: To describe nurses confusion around trans* terminology and to provide a lesson in Trans* 101 for readers. Of the estimated 9 million persons in the United States of America who are identified as lesbian, gay, bisexual and transgender, about 950,000 (0·2-0·5% of adult population) are identified as trans* (a term that encompasses the spectrum, including transgender, transsexual, trans man, trans woman and other terms). The Institute of Medicine (2011, The health of lesbian, gay, bisexual and transgender people: Building a foundation for better understanding. The National Academies Press, Washington, DC) identified transgender persons as an understudied population with significant need for health research, yet the nursing literature contains little guidance for educating nurses on trans* issues. This is a mixed methods structured interview design with nurse key informants. The scripted interview was based on the Health Care Equality Index, which evaluates patient-centred care to lesbian, gay, bisexual and transgender patients and families. These data were part of a larger research study that explored the current state of lesbian, gay, bisexual and transgender-sensitive nursing practice. Undergraduate nursing students recruited and interviewed 268 nurse key informants about gender inclusive forms (capable of identifying trans* patients) at their agencies. Only 5% reported use of gender inclusive forms, 44% did not know about inclusive forms, 37% did not understand what a gender inclusive form was and 14% confused gender with sexual orientation. The study demonstrated a critical need for education in gender identity and sexual orientation terminology. The lack of understanding of concepts and terminology may affect basic care of lesbian, gay, bisexual and transgender patients especially those who identify as transgender. © 2015 John Wiley & Sons Ltd.
    Journal of Clinical Nursing 08/2015; DOI:10.1111/jocn.12942
  • [Show abstract] [Hide abstract]
    ABSTRACT: To describe nurses' perceptions concerning their professional practice environment in mainland China and identify factors associated with these views. Globally, the environments in which nurses work influence the quality of nursing practice and health care. A cross-sectional descriptive survey using both paper- and online-based delivery modes was used. A convenience sampling method was used. The survey questionnaire was composed of sociodemographic items and the 38-item Chinese version of Professional Practice Environment survey. The content of the paper-based questionnaire was identical to the online survey. Pearson's chi-square test was conducted to compare the demographic characteristics of these two data sets. Descriptive statistics analysis included frequency, percentage, mean and standard deviation. Multiple linear regression analysis using the Backwards method was applied to identify independent predictors of each subscale of the 38-item Chinese version of Professional Practice Environment. A total of 573 questionnaires were analysed. The mean score of each subscale of the 38-item Chinese version of Professional Practice Environment in this study ranged from 2·66-3·05. All subscales except work motivation (3·05, standard deviation: 0·44) scored less than 3·0. Areas rated as most in need of improvement included control over practice, interpersonal interaction, supportive leadership and handling conflict, and staff relationships with physicians and autonomy. This study has identified nurses' perspectives regarding their workplaces in contemporary China. These data have provided an important baseline for developing and implementing culturally appropriate strategies to improve the working environment of Chinese nurses. A supportive and enabling work environment promotes professional development and the safety and quality of health care. Addressing these factors is important in optimising work place environments. © 2015 John Wiley & Sons Ltd.
    Journal of Clinical Nursing 08/2015; DOI:10.1111/jocn.12953
  • [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this study was to investigate the experiences of relatives who had a family member in an aged care facility subsequently transferred to an emergency department. The provision of timely and relevant patient information is vital for assessment and management of older patients presenting to the emergency department from aged care facilities. Older people are commonly accompanied by relatives who are an important resource for emergency department staff, providing medical information and assisting with treatment decisions. Investigating the experiences of relatives may provide key information to enable improvements in the delivery of emergency department care. This study used a descriptive qualitative design. Semi-structured interviews were undertaken with 24 relatives of residents who were transferred from an aged care facility to an emergency department in Victoria, Australia in the previous three years. Inductive content analysis was used to analyse the transcripts. Relatives reflected on four main themes following their emergency department visit: The need for clear communication; The role of relatives in emergency department care; How older people are perceived in the health care system and an Ability to provide specialised care. Many people link their emergency department experience to the quality of communication with emergency department staff, and participants in this study felt satisfied with their visit when they were included in discussions about treatment, and their role was recognised by staff members. In contrast, participants were dissatisfied with the care provided to their family member when staff members failed to communicate with them, or recognise their role in the care of the family member. The findings of this study emphasise the importance of effective communication between emergency department staff and family members, in relation to treatment and end-of-life care. © 2015 John Wiley & Sons Ltd.
    Journal of Clinical Nursing 08/2015; DOI:10.1111/jocn.12954
  • [Show abstract] [Hide abstract]
    ABSTRACT: To test eight person-centred key performance indicators and the feasibility of an appropriate measurement framework as an approach to evidencing the patient experience. The value of measuring the quality of patient care is undisputed in the international literature, however, the type of measures that can be used to generate data that is meaningful for practice continues to be debated. This paper offers a different perspective to the 'measurement' of the nursing and midwifery contribution to the patient experience. Fourth generation evaluation was the methodological approach used to evaluate the implementation of the key performance indicators and measurement framework across three participating organisations involving nine practice settings. Data were collected by repeated use of claims, concerns and issues with staff working across nine participating sites (n = 18) and the senior executives from the three partner organisations (n = 12). Data were collected during the facilitated sessions with stakeholders and analysed in conjunction with the data generated from the measurement framework. The data reveal the inherent value placed on the evidence generated from the implementation of the key performance indicators as reflected in the following themes: measuring what matters; evidencing the patient experience; engaging staff; a focus for improving practice; and articulating and demonstrating the positive contribution of nursing and midwifery. The implementation of the key performance indicators and the measurement framework has been effective in generating evidence that demonstrates the patient experience. The nature of the data generated not only privileges the patient voice but also offers feedback to nurses and midwives that can inform the development of person-centred cultures. The use of these indicators will produce evidence of patient experience that can be used by nurse and midwives to celebrate and further inform person-centred practice. © 2015 John Wiley & Sons Ltd.
    Journal of Clinical Nursing 08/2015; DOI:10.1111/jocn.12899
  • [Show abstract] [Hide abstract]
    ABSTRACT: To evaluate the introduction of Advanced Nurse Practitioners in a specialist, multi-professional palliative care context. The objective is to explore the core domains and competencies of the advanced nurse practitioner role in a multi-professional palliative care context. New models of health care and service delivery are emerging alongside expanded levels of autonomy, skills and decision-making for nurses and midwives. This has resulted in some confusion in the health service community internationally about the professional role and scope of the advanced nurse practitioner. A qualitative evaluation study (n = 21). Three phases of data collection were conducted over 10 months. Twenty-one participants took part from a specialist palliative care unit in one health board in a UK region spanning ANPs (n = 2) multi-professional staff (n = 14) and patients/carers (n = 5). Data collection methods included individual and focus group interviews with key stakeholders and observation of the advanced nurse practitioners at work and their reflexive diaries. The findings of this evaluation demonstrate that if the advanced nurse practitioner role can flourish it has the potential to shape 'new identities', re-construct the boundaries of nursing roles and emphasise the relationship based elements of excellent nursing work. The advanced nurse practitioner has the potential to enhance specialist palliative care service delivery through fluid role boundaries. The context in which advanced nurse practitioner roles are developed is important as acceptance of the role is linked to the co-construction of a different nursing identity. Our findings support the need to define, defend and name the work of advanced nursing roles. The advanced nurse practitioner roles were regarded as providing a unique contribution to service delivery and were characterised by fluid role boundaries which crossed the traditional disciplinary boundaries between nursing and medicine. © 2015 John Wiley & Sons Ltd.
    Journal of Clinical Nursing 08/2015; DOI:10.1111/jocn.12950
  • [Show abstract] [Hide abstract]
    ABSTRACT: The purpose of this study was to translate the Rowland Universal Dementia Assessment Scale into Chinese and to evaluate the psychometric properties (reliability and validity) and the diagnostic properties (sensitivity, specificity and predictive values) of the Chinese version of the Rowland Universal Dementia Assessment Scale. The accurate detection of early dementia requires screening tools with favourable cross-cultural linguistic and appropriate sensitivity, specificity, and predictive values, particularly for Chinese-speaking populations. This was a cross-sectional, descriptive study. Overall, 130 participants suspected to have cognitive impairment were enrolled in the study. A test-retest for determining reliability was scheduled four weeks after the initial test. Content validity was determined by five experts, whereas construct validity was established by using contrasted group technique. The participants' clinical diagnoses were used as the standard in calculating the sensitivity, specificity, positive predictive value and negative predictive value. The study revealed that the Chinese version of the Rowland Universal Dementia Assessment Scale exhibited a test-retest reliability of 0·90, an internal consistency reliability of 0·71, an inter-rater reliability (kappa value) of 0·88 and a content validity index of 0·97. Both the patients and healthy contrast group exhibited significant differences in their cognitive ability. The optimal cut-off points for the Chinese version of the Rowland Universal Dementia Assessment Scale in the test for mild cognitive impairment and dementia were 24 and 22, respectively; moreover, for these two conditions, the sensitivities of the scale were 0·79 and 0·76, the specificities were 0·91 and 0·81, the areas under the curve were 0·85 and 0·78, the positive predictive values were 0·99 and 0·83 and the negative predictive values were 0·96 and 0·91 respectively. The Chinese version of the Rowland Universal Dementia Assessment Scale exhibited sound reliability, validity, sensitivity, specificity and predictive values. This scale can help clinical staff members to quickly and accurately diagnose cognitive impairment and provide appropriate treatment as early as possible. © 2015 John Wiley & Sons Ltd.
    Journal of Clinical Nursing 08/2015; DOI:10.1111/jocn.12941
  • [Show abstract] [Hide abstract]
    ABSTRACT: To present the evidence in relation to early life nutrition and foetal programming for adult disease. Epigenetics is a new and growing area of study investigating the impact of the intrauterine environment on the lifelong health of individuals. Discursive paper. Searches were conducted in a range of electronic health databases. Hand searches located additional articles for review. Maternal search terms included: pregnancy; nutrition; diet; obesity; over nutrition; under nutrition. Offspring related search terms included: macrosomia; intrauterine growth restriction; epigenetics; foetal programming; childhood obesity; adolescent obesity; adolescent type 2 diabetes. Results indicate that foetal programming for adult disease occurs in response to particular insults during vulnerable developmental periods. Four main areas of foetal exposure were identified in this review: (1) under nutrition; (2) over nutrition; (3) gestational diabetes mellitus; and (4) infant catch-up growth. Numerous studies also described the trans-generational nature of foetal programming. Overall, foetal exposure to excess or insufficient nutrition during vulnerable developmental periods appears to result in a lifelong predisposition to obesity and adult disease, such as type 2 diabetes and cardiac disease. For the infant who has been undernourished during early life, a predisposition to renal disease also occurs. Pregnancy is a time when women are engaged in health systems and are receptive to health messages. These factors suggest that pregnancy may be an optimal time for dietary education and intervention. There is a particular need for education on healthy diet and for interventions which aim to limit over consumption of calories. © 2015 John Wiley & Sons Ltd.
    Journal of Clinical Nursing 08/2015; DOI:10.1111/jocn.12951
  • [Show abstract] [Hide abstract]
    ABSTRACT: The purpose of this review was to explore what is known about interruptions and distractions on medication administration in the context of undergraduate nurse education. Incidents and errors during the process of medication administration continue to be a substantial patient safety issue in health care settings internationally. Interruptions to the medication administration process have been identified as a leading cause of medication error. Literature recognises that some interruptions are unavoidable; therefore in an effort to reduce errors, it is essential understand how undergraduate nurses learn to manage interruptions to the medication administration process. Systematic, critical literature review. Utilising the electronic databases, of Medline, Scopus, PubMed and CINAHL, and recognised quality assessment guidelines, 19 articles met the inclusion criteria. Search terms included: nurses, medication incidents or errors, interruptions, disruption, distractions and multitasking. Researchers have responded to the impact of interruptions and distractions on the medication administration by attempting to eliminate them. Despite the introduction of quality improvements, little is known about how nurses manage interruptions and distractions during medication administration or how they learn to do so. A significant gap in the literature exists in relation to innovative sustainable strategies that assist undergraduate nurses to learn how to safely and confidently manage interruptions in the clinical environment. Study findings highlight the need for further exploration into the way nurses learn to manage interruptions and distractions during medication administration. This is essential given the critical relationship between interruptions and medication error rates. Better preparing nurses to safely fulfil the task of medication administration in the clinical environment, with increased confidence in the face of interruptions, could lead to a reduction in errors and concomitant improvements to patient safety. © 2015 John Wiley & Sons Ltd.
    Journal of Clinical Nursing 08/2015; DOI:10.1111/jocn.12944
  • [Show abstract] [Hide abstract]
    ABSTRACT: To explore nurses' strategies that may support the sense of coherence in people with dementia. People with dementia are often described as people with no resources, people who need support from family or from healthcare personnel to function in everyday life. Despite the disease, some people still have the resources needed to cope well with parts of their lives and experience coherence. To date, no research has explored any nurses' strategies that may support the sense of coherence in people with dementia. The design of the study is qualitative and exploratory. Data were collected by participant observation and focus group interviews. Sixteen registered nurses from two different Norwegian nursing homes were recruited and participated in the study. Qualitative content analysis was used to analyse the data. The empirical material consisted of field notes from participant observation and transcripts from focus group interviews. Three generic categories were identified as strategies that may support sense of coherence in people with dementia: 'Finding and nurturing the individual's resources', 'Customising meaningful activities' and 'Finding creative solutions'. These categories were identified as strategies that may support and possibly enhance the sense of coherence in people with dementia. The findings provide an empirical base for assuming that with support and help from nurses, people with dementia may experience and strengthen their sense of coherence, therefore, the nurses need to be aware of the activities that may support and possibly enhance the sense of coherence in people with dementia. Despite the contextual limitations, this study highlights the need to identify and nurture resources in people with dementia, thus supporting their sense of coherence. The findings may contribute in enhancing the quality of care for people with dementia. © 2015 John Wiley & Sons Ltd.
    Journal of Clinical Nursing 08/2015; DOI:10.1111/jocn.12945
  • [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this study was to describe people's perceptions of needs to feel confident in self-care for minor illnesses as well as their perceptions about supporting and obstructing factors in the practice of self-care. Minor illness constitutes a large part of primary care, and patients' attendance to doctors' appointments for minor illness has been seen to increase future attendance for the same condition. Almost half of the consultations with telenurses result in the provision of self-care advice. A cross-sectional survey. Primary data were collected using a questionnaire, and the study participants (n = 315) were randomly selected from the national Swedish address register. Having knowledge and receiving health care advice and reliable information were perceived to be needs in order for participants to feel confident in self-care. Having family or friends to consult with was perceived to be a positive factor influencing confidence in self-care, especially for persons under the age of 35. Health care services were perceived to support self-care practice by offering easy access to care, giving information about self-care, and offering increased follow-up after consultations. Lack of knowledge, along with difficulties being away from work, were obstructing factors in the practice of self-care. Young age was the factor influencing people's perceptions of needs and supporting factors the most. Young age and low knowledge scores about minor illnesses were the two factors that had the most influence on perceived obstructing factors. Nurses play a major role in the promotion of self-care and in the dissemination of self-care advice. If health care services fail to meet the needs of care-seekers with minor illnesses, patients might turn to out-of-hours clinics and emergency departments for help. © 2015 John Wiley & Sons Ltd.
    Journal of Clinical Nursing 08/2015; DOI:10.1111/jocn.12888
  • Journal of Clinical Nursing 08/2015; DOI:10.1111/jocn.12935
  • [Show abstract] [Hide abstract]
    ABSTRACT: This study investigates health-related quality of life in older patients, over one year following an intensive care unit stay. Health-related quality of life is an important outcome when assessing long-term effectiveness of intensive care treatment, and to assist patients, their relatives and healthcare professionals in making treatment decisions. Prospective non-randomised longitudinal study. The Short Form Health Survey 36 was administered 1 week after an intensive care stay (retrospective baseline), and after six months and 12 months to the study population and to an age-matched comparison group at recruitment (baseline), and after six months and 12 months. Demographic data, admission diagnosis, length of stay, severity of illness, pain, anxiety, agitation, and intratracheal suctioning, turning and intubation were recorded. Recruitment period: December 2008 to April 2011. Health-related quality of life of the older patients was significantly lower than the comparison group, both before and after the intensive care unit stay, and showed great individual variability. Within group scores, however, were stable over the year. Both physical and mental health scores were lower for the older patients. Renal failure, cardiac surgery and illness severity were associated with lower physical health scores. Cardiovascular illness, intratracheal suctioning and turning were associated with lower mental health scores. Health-related quality of life was lower in older patients than in the age-matched group but remained stable over one year. Older patients with severe illnesses, acute renal failure or who have had cardiac surgery, need additional support after hospital discharge due to functional restrictions. Discharge planning should ensure that this support would be provided. Special attention should be given to develop and use methods to reduce distress during routine intensive care interventions such as intratracheal suctioning or turning. © 2015 John Wiley & Sons Ltd.
    Journal of Clinical Nursing 08/2015; DOI:10.1111/jocn.12904